Clubhouse Pediatric Dentistry of West Jordan
NPI #1639654684 in Midvale, Utah
Provider Information
- NPI Number
- 1639654684
- Entity Type
- Organization
- Organization Name
- Clubhouse Pediatric Dentistry of West Jordan
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- CAPSTONE LLC
- Primary Specialty
- Dentist - Pediatric Dentistry
- Enumeration Date
- Sep 26, 2018
- Last Updated
- Sep 26, 2018
Practice Location
Authorized Official
- Name
- MRS. JENNIFER LOUISE ROBISON
- Title
- CREDENTIALING COORDINATOR
- Phone
- (208) 520-1514
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Pediatric Dentistry — Pediatric Dentistry |
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